scott@vtx-cpd.com
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Replying to Rachel F. 13/03/2023 - 14:17
Hey!
Glad you enjoyed it. I will get Andy to have a look at this ASAP.
Scott 🙂
Replying to Sarah H. 12/03/2023 - 09:53
Sarah!
Lovely to have you here. Time flies when you are having fun I suppose!
Thanks for your kind words, that means a lot. I will indeed link to some more GI podcasts.
Francesco is such a lovely guy!
I really hope you enjoy the course.
Scott 🙂
Replying to Helen Bradley 22/02/2023 - 10:51
Hey again!
I also thought this review would be helpful:
https://drive.google.com/file/d/1TB3rf4UecB9qglDiBsYLYhDjBhQ2Why3/view?usp=share_link
Scott 🙂
Replying to Helen Bradley 22/02/2023 - 10:51
Hey Helen.
Sorry for the delay in getting back to you. I asked this question to one of our ECC specialists over on the ECC course and got the following back:
“So… yes I would use them in dogs with severe haemorrhagic diarrhoea/gastroenteritis a lot. I think I may be biased to the ones we see, so I am talking about the ones that come unwell with signs of hypovolaemic shock and severe dehydration/haemoconcentration. These ones typically come with high PCV and “normal” TS so for example 65%/60g/L, in these ones I know that if hypovolaemic I will need to fluid resuscitate so may end up needing 5-20mL/kg over a few boluses and then I will need high rates of IVFT to account for on going losses, rehydration and maintenance and when you calculate this sometimes is as high as 6-8mL/kg/h. There is two sides to this and one is that we know that actually the use of crystalloids itself will damage the glycocalyx and you will gave shedding and then this will lead to increased vascular permeability etc. and the second side to this is that when my PCV is normalised when the patient is rehydrated, say comes from 65 to 45%, I know my solids will ave tanked and probably be from 60 to 30-40g/L and at this stage this becomes a problem also with on going increased permeability, increased oncotic pressure etc. So that is why I tend to come in early with plasma to prevent this from happening, and when plasma is used as is a colloid… you can also allow yourself to use lower fluid rates so in the same example if you calculated you may need 6-8mL/kg/h if you combine plasma and crystalloids you may get away with 4-5mL/kg/h instead.
For the hypoalbuminaemic GI patients… I don’t think there is a number really. So if I think PLE that I have treated alongside medicine; these patients are different as stable so unless I had to fluid resuscitate or need IVFT I would not consider it, even if their albumin is really low. Now for a PLE patient who isn’t great and is now third spacing and say it has abdominal effusion, and that is increasing the abdominal pressure which is compromising the gut blood supply and they are not doing great. I tend to remove abdominal fluid really slowly over a few hours, then replace with plasma – and the times we have done this they tend to have really low alb on low teens.”
Hope that helps.
Scott 🙂
Replying to Rosie Marshall 08/03/2023 - 11:33
Hey Rosie.
Lovely to hear from you. I hope you are well.
So I never heard back from VPIS about this! I have spoken to several people about this topic, including a couple of ECC specialists.
For acute ingestion of ibuprofen managed symptomatically with emesis and IVFT I would not routinely use omeprazole prophylactically.
I would only use omeprazole in these cases when there are ongoing, severe GI signs or any evidence of melena or haematemesis.
What did you do with your case? Hope this helps.
Scott 🙂
Replying to Siriol B. 08/03/2023 - 18:32
Hello!
Great question. The idiopathic cases, most of them require lifelong management. The expectation would not be that oesophageal function would return. The aim of any medical management would be to reduce clinical signs as much as possible, but not a return to normal function.
Interesting comments regarding the feeding. Having a dog with a megaoesophagus is intense, and I have a lot of respect for owners.
Scott 🙂
Replying to Sybil Dryburgh 08/03/2023 - 18:57
HAHAHAH!
It is a tough read!
Scott 🙂
Replying to Gisela T. 08/03/2023 - 21:39
Brilliant suggestions Gisela!
I will make sure to cover this!
Scott 🙂
Replying to Sophie Ponter 08/03/2023 - 14:44
Thank you Sophie.
Great of you to share all of this. This is exactly how I understand the use of platelet concentrate. It is all about plugging the gaps… literally.
We struggle most with IMTP patients in the initial stages so anything else that can help control bleeding is helpful!
Thank you again.
Scott
Replying to Madeleine Smith 08/03/2023 - 12:30
Hello Maddie!
Great to see you here! Thank you so much for joing the course.
Let me know if you have any questions at anytime!
Scott 🙂
Replying to Madeleine Smith 08/03/2023 - 12:31
Thnaks Madeleine.
I am looking forward to it!
See you then.
Scott 🙂
Replying to Madeleine Smith 08/03/2023 - 12:31
Thnaks Madeleine.
I am looking forward to it!
See you then.
Scott 🙂
Replying to Jennifer Cartwright 03/03/2023 - 21:40
Yes!
Apart from being cool it does have a urinary theme as the dog had ongoing problems with UTIs. I have popped some information about the case below for everyone:
“This is the radiograph of a dog that had a spinal cord injury and subsequent loss of control of urine voiding… in this case the solution to the problem was pretty cool!
Loss of control over urine voiding is a common complication after spinal cord injury or other disorders of the nervous system, and may be permanent. Often, because of loss of supraspinal regulation, incoordination of detrusor and sphincter contraction develops. This causes a functional obstruction that reduces the ability to void urine and impairs emptying of the bladder by manual expression. Management of overflow incontinence consequent to dyssynergia can be difficult in dogs. Management options include intermittent catheterization, manual expression, and indwelling catheterization, but these are all associated with risk of urinary tract infections.
For many years a “sacral anterior root stimulator” has been available to paraplegic humans which permits bladder emptying on demand through electrical stimulation of the sacral spinal nerves. This type of technique is also available for dogs!
Hope that helps.
Scott 🙂
Replying to Jennifer Cartwright 03/03/2023 - 21:37
Thanks Jenny.
You probably did put the link on there. I make lots of notes when I am watching your webinars… so I probably got confused.
Loving watching the content so much!
Scott 🙂
Replying to Neus E. 05/03/2023 - 12:31
Thanks, Neus!
This is so helpful. Overall, I think I need to use it more. I will most often see PLE patients with very low albumin and I think I should probably using plasma for oncotic support in these patients.
Thanks again for this information.
Scott 🙂
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